I still come across people who believe Trump won the 2020 election, that the attack on the US Capitol on January 6, 2021, was an act of patriotism, that Trump’s subsequent indictments and felonies were Biden’s work, that most immigrants are criminals, that Democrats are evil, that Jews are trying to replace white Christians born in America, that Muslims can’t be trusted, that a significant amount of voting is fraudulent, that we’re winning the war against Iran, that the economy has never been as good, that climate change is a hoax, that Canada poses a threat to the United States and it’s only fair for Lake Ontario to be renamed Lake America.

To label these people “deluded” is to overlook an entire world created by Trump and his assistants, Cabinet secretaries, “spokespeople,” other political appointees, Republican enablers in Congress and state legislatures, and billionaire accomplices in the media (Musk, Murdoch, Pichai, Bezos, Zuckerberg, the Ellisons) — all of whom have reinforced Trump’s “artificially fabricated insanity,” as the philosopher Hannah Arendt once termed the technique of totalitarian tyrants.

Google, for example, just updated its Maps application to rename Lake Ontario “Lake America.” ** (It’s already relabeled the Gulf of Mexico the “Gulf of America.”)

Totalitarian movements, Arendt wrote, succeed not by convincing people of a specific lie but by creating a consistent, logical fictional world that defies ordinary common sense and human experience.

Which raises the questions that a growing number of Americans are asking: Is Trump insane? Are those who believe Trump’s artificially fabricated world insane? Are they making the rest of us insane?

I remember during the Biden administration when a panel of medical experts — the U.S. Preventive Services Task Force — recommended that doctors screen all adult patients under 65 for depression and “anxiety disorders.” The advisory group said the guidance was intended to deal with a rise in mental health disorders that were going undetected and untreated.

The advice highlighted the........

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